Method using a global server for providing patient medical histories to assist in the delivery of emergency medical services

ABSTRACT

An Internet based method for assisting in the rapid delivery of medical information direct to the site at which emergency assistance is being performed uses a global database for warehousing patient history information, which is fetched over the Internet on demand. In one embodiment, medical providers use an access code carried by the injured party and without which access is denied. The access code may be carried as a barcode and as an imprinted number on a bracelet or on a card carried by the individual. Patient information is transmitted over a network, either wireline or wireless, the Internet or wide area network, to a computer or personal digital assistant available to emergency personnel. In one embodiment, patient history information access is determined through the use of an access code reader, by entering the patient access code manually or by entering the patient&#39;s name as a last resort. Additionally insurance information can be made available to shorten emergency room admission procedures. Lastly, the patient&#39;s card or bracelet can allow for patient history to be downloaded and saved. Thus in emergency situations, the information can be uploaded from the card or bracelet to the healthcare providers&#39; viewing screens.

FIELD OF INVENTION

This invention relates to the delivery of emergency medical services andmore particularly to a method for providing patient medical history overthe Internet.

BACKGROUND OF THE INVENTION

It will be appreciated that time is of the essence in the delivery ofemergency services. As is well known, with a severed artery anindividual can die within eight minutes. Moreover, there is a so-called“golden hour” in which if appropriate medical procedures are notadministered, the likelihood of survival is substantially diminished.

In the past, a limited amount of medical history has been carried onbracelets worn by a stricken individual which at least instructs theEMTs or other emergency care professionals as to any allergic reactionsthat the individual may have. It can also alert to life threateningdiseases such as AIDS so as to protect emergency personnel.

However, complete patient records have so far been unavailable to theemergency medical practitioner at the scene or at the point at whichemergency help is administered. As a result, emergency medical personnelare at a great disadvantage when treating an individual in extremis.

There is therefore an urgent need to provide patient histories on thespot to assist medical providers in order to save lives or better renderemergency assistance.

Such assistance would desirably be with the patient's consent, althoughability to rapidly deliver patient records might take precedence overobtaining consent. Consent may however, play an important role.

As is usual, much of the patient's medical history is kept as a privaterecord by his or her physician, by his or her hospital, or by his or herinsurance company. Privacy issues surrounding the release of thisinformation have in general resulted in large and unacceptable delays ingetting this information to the primary healthcare provider. The resultshave been that people in emergency situations are denied the benefits ofproviding up-to-date information when trying to obtain treatment. Thusnot only is patient history unavailable, such information when itbecomes available, is available much later in the process.

Thus, delays in disseminating patient information are the result ofprivacy concerns, and for this reason patient information is notroutinely transmitted anywhere outside a hospital environment, much lessover the Internet. Moreover, present systems deny the patient theability to consent to the transfer of the records to the appropriatehealthcare provider under any circumstances. For this reason theindividual has no choice in the matter and if unconscious is unable togive such consent in cases of emergency.

SUMMARY OF THE INVENTION

In the subject system, a global database is provided at a server linkedvia the Internet or other means to the site at which emergencyassistance is rendered. The global database has access to the patient'smedical history, and optionally insurance information, which iswarehoused at one location. This information is instantly transmittedover the Internet to either a computer in an emergency room, to a rescuevehicle, or to a personal digital assistant carried by emergencypersonnel. The result is instant access to patient histories whenever itis needed.

If privacy is an issue, access to the information over the Internet isauthorized, in one embodiment by a user ID or password, which can be abarcode and an imprinted number on a bracelet or a card within one'swallet. Alternatively, manual entry of the patient's access codeprecludes the necessity of access code readers.

In a preferred embodiment, each emergency health care provider isprovided with a scanner which accesses the password or ID and transmitsthis password or ID to the global database server. The global databaseserver then downloads or fetches the information over the Internet tothe health care provider at the scene so as to permit the health careprovider to make intelligent decisions about the treatment of thestricken individual.

In one embodiment, medical information can be entered at the scene usinga data form provided for the purpose that can be e-mailed to thehospital before arrival, and is transmitted back to the global databaseserver for storage.

For those situations in which privacy is an issue, in one embodiment ofthe subject invention, it is only by virtue of the consent of eachindividual that his or her information is provided to the emergencyhealth care provider. Moreover, the individual may, at his election,wish to divulge only a certain portion of his medical history, which canbe encoded and honored at the global database server.

While it may be unwise for a particular individual to limit theinformation seen by the emergency medical technician or physician, ifsuch restricted access will cause the individual to give his or herconsent, then the net benefit is still positive. Alternatively, theoperator of the global database server may upon receipt of a request forrestricting information contact the individual and discuss whatinformation would be more appropriate and what information might berestricted. The simplest method is the organization of information bypatient visit date (PDFs). Thus, the patient can indicate what date heor she does not want posted.

It will be appreciated that as part of the subject invention, it ispossible for the global database server to be in the form of a number ofnetworked database servers, with each server in each location acting asa regional server for that specific area. This prevents backlogs andprovides realtime access to the information.

What is provided is on-the-spot access to patient medical informationover a globally networked system. This allows for easier access tomedical and insurance information, which in turn allows time to be savedand complete information to be received. The subject system saves timein emergency situations especially in emergency rooms or at the rescuescene and provides complete information for health care providers,particularly if the patient is unconscious. Because the information isaccessible over the Internet, patient information can be accessed fromany global location quickly, particularly because of the use of serversin various global locations. Moreover, any network medium including acomputer, a handheld device such as personal digital assistant or anytype of display linked to the network may be utilized. If the device towhich the information is downloaded includes a wireless transmissionsuch as a cell phone, then EMT practitioners or other medicalprofessionals can have the additional benefit of e-mailing informationor prescriptions to colleagues or pharmacies from the same screen.

As can be seen, what is provided is a centralized healthcare networkconnected to the far reaches of the world to assist emergency care byproviding realtime access to patient histories to assist emergency careproviders.

In summary, an Internet based method for assisting in the rapid deliveryof medical information direct to the site at which emergency assistanceis being performed uses a global database for warehousing patienthistory information, which is fetched over the Internet on demand. Inone embodiment, medical providers use an access code carried by theinjured party and without which access is denied. The access code may becarried as a barcode and as an imprinted number on a bracelet or on acard carried by the individual. Patient information is transmitted overa network, either wireline or wireless, the Internet or wide areanetwork, to a computer or personal digital assistant available toemergency personnel. In one embodiment, patient history informationaccess is determined through the use of an access code reader, byentering the patient access code manually or by entering the patient'sname as a last resort. Additionally insurance information can be madeavailable to shorten emergency room admission procedures.

Lastly, the patient's card or bracelet can allow for patient history tobe downloaded and saved. Thus in emergency situations, the informationcan be uploaded from the card or bracelet to the healthcare providers'viewing screens.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other features of the subject invention will be betterunderstood in connection with the Detailed Description in conjunctionwith the Drawing of which:

FIG. 1 is a diagrammatic representation of the subject system in which ahealthcare professional attending an injured party is provided with thepatient's record through the utilization of the Internet and a globaldatabase coupled to an Internet server;

FIG. 2 is diagrammatic illustration of an access code entry system inwhich the access code is carried on a bracelet;

FIG. 3 is a diagrammatic representation of an access code entry systemin which the access code is carried on a card carried by an individual;

FIG. 4 is a block diagram of a global server coupled to regional serversto permit realtime data processing to provide the patient's record atthe injured party;

FIG. 5 is a diagrammatic illustration of a data entry structureincluding an initial web page in which the insurance agencies andhealthcare providers can provide input to the global database, and inwhich the patient and/or those surrounding him can view the medical andinsurance information from the global database; and,

FIG. 6, is a flow chart of one embodiment of the subject invention.

DETAILED DESCRIPTION

It will be noted while the illustrated embodiment is described in termsof access codes, in the general case the subject invention involves therealtime Internet transfer of patient histories.

With this understanding and referring now to FIG. 1, a system 10includes an injured party 12, an access code providing device 14 whichis read by an access code entry device 16, which in one embodiment canscan the access code from, for instance, a barcode carried by a braceletor a card carried in the individual's wallet. Access code entry can alsobe done manually through a keypad or by whatever means is required inorder to ascertain the access code associated with the injured party.

The access code is entered into a computer 18, which in the illustratedembodiment is a personal digital assistant having a screen at which apatient record 20 is accessible.

A healthcare professional, here illustrated at 22, is shown attendinginjured party 12 and is utilizing patient records 20 to determine theparticular procedures to be utilized in the treatment of the injuredparty.

The information on this screen is provided, in the illustratedembodiment, over an RF link 26 to a cell tower 28 which is connected tothe Internet 30 and thence to a server 32 which is turn connected to aglobal database 34. The global database is provided with the patientrecords here illustrated at 36 which can be composed ofhospital/physician records 38, CT scans, NMRIs, X-rays 40, charts andgraphs and optionally insurance data 42.

In operation, the healthcare professional, here illustrated at 22,ascertains the access code from the injured party and enters the accesscode through the local computer 18 which is then transmitted over theInternet to a server 32. Server 32 determines access, here illustratedat 44, and accesses database 34 with this access code to provideinformation from server 32 through Internet 30, cellsite 28 and RF link26 to computer 18.

What is provided is an onsite patient record which is authorized by theutilization of the patient's access code carried by him or her. In thismanner, the patient gives actual consent to the accessing of his or herpatient records by virtue of carrying the access code on his or herperson. In one embodiment, no access is permitted to the patient recordswithout the injured parties actual consent. This actual consent isachieved through the provision of an access code to the individual andby virtue of the access code having been pre-coded into the globaldatabase.

If the patient is unconscious, then the permission to access his or herpatient's record is automatic through access code entry by thehealthcare provider or other professional.

It will be appreciated that in the illustrated embodiment there is noaccess to the patient's records absent his explicit consent as denotedby the carrying of the card or other device carrying his or her accesscode.

Optionally, as illustrated at entry device 50, those on the scene canenter data and transmit it back through the Internet and into the globaldatabase to modify the patient record in terms of care and other mattersdeemed pertinent by the healthcare provider at the scene. Also, computer18 can be utilized to transmit prescriptions and other data neededelsewhere through the transmission path here established by RF link 26.

It will be appreciated that while the subject system is illustrated asbeing a wireless system, a hardwired system such as a computer in anemergency room is within the scope of this invention.

What is therefore provided is rapid access to authorized patientinformation which is useful both in the care of the injured party and inascertaining the insurance qualifications of the individual, if such isnecessary. The two-way communication link in which the patient record isan intrigal part is utilized, in one embodiment, to permit theforwarding of this information to further agencies such as a pharmacy orother experts so that prompt and accurate diagnosis can be made of thepatient condition along with an appropriate treatment regimen.

Referring now to FIG. 2, one way of providing an access code is byvirtue of a bracelet 52 which has an access code 54 imprinted thereon,in one embodiment as a barcode. Other types of access code indicationsuch as magnetic stripes in internally carried magnetic elements orcolor-coding may be utilized in the generation of the access code.

Referring to FIG. 3, the same type of information can be encoded onto acard 56 in whatever manner as is convenient as in the case of thebracelet of FIG. 2.

Referring to FIG. 4, and as is described hereinbefore, a global server60 may be coupled via the Internet or other means to regional servers62, 64, 66, 68, 70 and 72. Such a global hosting system is described inU.S. Pat. No. 6,108, 703 issued to F. Thomson Leighton et al. on Aug.22, 2000. The purpose is to be able to transfer the centrally-generatedinformation to local servers to reduce the time to transfer certaindocuments. This is particularly useful when the documents are not merelytext but rather include images such as X-rays, CT scans, NMRIs or otherpictorial data which must be used in the generation of a treatmentregimen for the injured party. In the case illustrated, the servers maybe as far as Washington state or Virginia and may be grouped as isconvenient for the transmission of the patient information.

Referring now to FIG. 5, a data entry structure is shown as an initialweb page 80 which includes from left to right an insurance agency ID 82,a particular password or access code 84, a patient ID such as thepatient name 86, a password or access code 88, a healthcare provider 90and an access code 92.

From the insurance agency's point of view the insurance agency may wishto access patient information, here illustrated at a new screen 94, inaccordance with the patient ID 96 and may choose to add or editinsurance information as illustrated at 98 which is then passed to theglobal database.

Likewise, healthcare provider 90 with the appropriate password or accesscode can be provided with a new screen 100 and a patient ID 102 to addor edit medical information to the global database as illustrated at104, with appended insurance information as illustrated at 106 garneredfrom the global database.

Finally, the patient may be able to view his or her medical andinsurance information by entry of a patient ID and a password or accesscode so that the entire record may be viewable to the patient asillustrated at 110 which information comes from the global database.Thus, the patient can monitor his or her treatment.

Referring now to FIG. 6, one of the best ways to provide patienthistories is by saving the medical information as a PDF file. In theglobal database the newest entry is stored in one instance in a dataform which is stored as a new PDF file.

Having this type of information available, the information may beprovided over the Internet by providing a specialized web page for eachpatient. As can be seen from FIG. 6, a viewer 120 may be using a viewerID 120 to access a new screen 122 which upon receipt of the patient ID124 provides a list of patient dates 126. These are then clicked at 128to provide a PDF history 130 presented over the Internet.

New entries are provided by the new entry data form 132 which providesentries 134 such as blood pressure, diagnostic data and charts or graphswhich result in a new PDF 136 being generated. This is submitted to beincluded on the database as illustrated at 138.

Additionally, e-mail prescriptions can be provided over the Internetfrom the entries at 134 as illustrated at 140.

While there are many methods to transmit data from a hospital or doctorsoffice, in one embodiment the patient records, if saved on database, canbe e-mailed and then converted to a PDF file at the global database.

On the other hand, the patient records at the hospital or doctor'soffice can be scanned and e-mailed to the global database where they areconverted to PDF files. In this manner, regardless of the form in whichpatient records are kept, they can be provided in a PDF format by merelyscanning them and transmitting the PDF file via e-mail. As a result,they can be preserved in the database as a PDF or other type of file.

While the PDF modality has been described herein, it will be appreciatedthat any universal method may be applied to the transmission of datafrom a hospital or a doctor's office to the global database. Moreover,patient records may be transmitted to the ultimate user through amodality other than PDF files. If utilizing a universal format, PDFfiles need not be used. Rather, the electronic form in which thepatient's record are kept may be used directly. The advantage of usingPDF or like files is to be able to transmit to the ultimate recipient,namely the medical care provider, not only whatever handwritten recordsexist but also the signatures on these records, and also any X-Rays, NMRrenderings or indeed charts of any kind, that need not be in aparticular format in order to be transmitted to the end recipient.

Having now described a few embodiments of the invention and somemodifications and variations thereto, it should be apparent to thoseskilled in the art that the foregoing is merely illustrative and notlimiting, having been presented by the way of example only. Numerousmodifications and other embodiments are within the scope of one ofordinary skill in the art and are contemplated as falling within thescope of the invention as limited only by the appended claims andequivalents thereto.

1. A method of providing patient histories to a site at the location ofa patient in need of medical attention, comprising the steps of:providing patient histories at a centralized location in a globaldatabase coupled to the Internet by a server; and, wirelessly accessinga predetermined patient history over the Internet from a wirelessterminal at said site and uploading patient information from said site.2. The method of claim 1, wherein said patient history is onlytransmitted when authorized by the patient.
 3. The method of claim 2,wherein authorization is in the form of an access code carried by thepatient.
 4. The method of claim 3, wherein said access code is obtainedfrom the patient and is transmitted to the server associated with saidglobal database.
 5. The method of claim 4, wherein the access code iscarried by the patient.
 6. The method of claim 5, wherein the accesscode is in the form of a bar code and wherein a bar code reader is usedto read the access code and transmit the access code to the serverassociated with said global database.
 7. The method of claim 5, whereinthe access code is carried on a bracelet.
 8. The method of claim 5,wherein the access code is imprinted on a card adapted to be carried. 9.The method of claim 1, wherein said global database is decentralizedthrough the use of regional databases, each having its own server andeach carrying patient histories so that access to the patient historycan be on a real time basis to permit timely treatment.